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Can an Insurer Deny Death Benefits to a Widow With Children?

Last week, we discussed an article published by The Texas Tribune about Crystal Davis, a widowed wife of two children who was forced to fight for workers’ compensation benefits from her deceased husband’s workplace insurer.

Crystal’s husband, Wayne, worked for Burger King as a “Sales, Profit and Operations Coach.” His job required traveling on the road most of the time. Unfortunately, he was killed in a head-on collision while driving to one of the Burger King restaurants.

The Division of Workers’ Compensation (DWC) ruled Wayne’s death as a workplace fatality and ordered that Crystal and her two kids receive workers’ comp benefits. However, ACE American Insurance Company, the insurer for Burger King, appealed the decision. The company argued that Wayne was not on the clock at the time of the accident.

Not able to afford an attorney, Crystal went to the Office of Injured Employee Counsel (OIEC) to have an ombudsman assigned to her case. Ombudsmen can only help answer questions regarding how the system works; they cannot make decisions that are in the best interest of their client.

Crystal requested a benefit review conference (BRC) with the DWC, which is the first part of the dispute process. Again, the DWC sided with her, but ACE appealed that decision.

Even after going before the workers’ compensation appeals panel, the insurer still lost, but this did not stop it from filing a lawsuit against Crystal and each of her two kids.

ACE wanted to stop the weekly payments to the Davis family and wanted the money returned. The attorney representing the insurer told Crystal that he planned to appeal the case as far as possible.

Does Texas Require Workers’ Comp to Cover Certain Benefits?

Although state law requires workers’ compensation policies to include burial expenses and income for the family of an employee killed on a job, employers and their insurers can still dispute the claims.

This frustrating story shows how far an insurance company can go to try to deny benefits. Fortunately, the publicity surrounding this case caused ACE to drop its lawsuit against Crystal and her two children. However, had the media not published this story, this lawsuit would still be going on.

Workers’ comp claims should not require fighting for your benefits. Unfortunately, this happens quite often. It is important to hire an experienced law firm that is knowledgeable about workers’ comp and can help you secure your claim against the employer and its insurer.